The representation of the body in the brain keeps into account several sensory signals from the body itself (somatosensation) and from the surrounding environment. Efficient and highly adaptable multisensory integration of such signals is vital to build up the sensory experience of bodily-related stimuli, including painful ones. Chronic pain conditions are known to induce maladaptive neural plasticity that disrupt body representation and sensory integration, thus strengthening and maintaining pain sensations.
Recent findings show that chronic pain experience can be successfully modulated by sensory manipulations that capitalize on key mechanisms of multisensory integration. Among such techniques, the mirror box training has gained a certain popularity among clinicians facing chronic pain conditions, such as neuropatic pain and phantom limb pain. Examples of its clinical applications will be given, together with clues on its neural underpinnings and current explanatory theories of its bottom-up multisensory effects. On the other side, neuromodulation, such as tDCS, or TMS, have been recently used with some success as top-down modulation of chronic pain, as will be discussed.
Practical demonstrations, especially centred on the use of the mirror box in the treatment of different pain conditions, will be provided as a complement of the theoretical framework.
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